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Procedure
Practice 09/15/00 - Coding
Recommendations
ICD-9-CM
Code Changes
as of October 1, 2000
Diagnostic
Codes - V
Codes - E
Codes - Procedure
Codes
October 1, 2000, marks the effective date for
some important ICD-9-CM code changes. It has been two years
since the codes were updated, and this year coders will see
a number of code additions, deletions, and revisions. This
article reviews these changes chapter by chapter.
Infectious and Parasitic
Diseases (001-139)
Under category 007, Other protozoal diseases,
a new subcategory, 007.5, has been added
for an intestinal disorder called Cyclosporiasis.
This diarrheal illness is caused by ingestion of tiny Cyclospora
protozoa often found on imported fruits.
Three codes have been added under category 082,
Tick-borne rickettsioses, to identify several different
types of a flu-like illness called ehrlichiosis. This illness
may occur after being bitten by an arthropod (e.g., a spider).
| 082.40 |
Ehrlichiosis, unspecified |
| 082.41 |
Ehrlichiosis Chafeensis
(E.chafeensis) |
| 082.49 |
Other ehrlichiosis
|
Blood and Blood-Forming
Organs (280-289)
The following codes have been added to category
285, Other and unspecified anemias:
| 285.21 |
Anemia in end-stage renal
disease |
| 285.22 |
Anemia in neoplastic
disease |
| 285.29 |
Anemia of other chronic
disease
|
Mental Disorders (290-319)
As of October 1, code 294.1, Dementia in
conditions classified elsewhere, becomes invalid. Instead,
coders will need to select one of the two following codes
depending upon the type of dementia documented:
| 294.10 |
Dementia in conditions
classified elsewhere without behavioral disturbance |
| 294.11 |
Dementia in conditions
classified elsewhere with behavioral disturbance
|
Nervous System and Sense
Organs (320-389)
Subcategory 372.8, Other disorders of conjunctiva,
will be invalid as of October 1. The new codes that appear
in this chapter are:
| 372.81 |
Conjunctivochalasis |
| 372.89 |
Other disorders of conjunctiva
|
Respiratory System (460-519)
A total of seven new codes were added to this
chapter. Coders may be especially interested in the four new
codes that describe exacerbations of chronic asthma. In the
past, codes did not exist to identify what is often referred
to as "asthma attack," so coders had no means of
capturing the acuity of the illness. The new codes that debut
in this chapter are:
| 477.1 |
Allergic rhinitis due
to food |
| 493.02 |
Extrinsic asthma with
acute exacerbation |
| 493.12 |
Intrinsic asthma with
acute exacerbation |
| 493.22 |
Chronic obstructive asthma
with acute exacerbation |
| 493.92 |
Unspecified asthma with
acute exacerbation |
| 494.0 |
Bronchiectasis without
acute exacerbation |
| 494.1 |
Bronchiectasis with acute
exacerbation |
Effective October 1, code 494, Bronchiectasis,
will no longer be valid.
Digestive System (520-579)
Under category 558, Other noninfectious
gastroenteritis and colitis, code 558.3,
Allergic gastroenteritis and colitis, has been added.
Genitourinary System
(580-629)
Code 600, Hyperplasia of prostate,
will be invalid as of October 1. Instead, additional codes
have been added to further describe the various types of prostate
enlargement:
| 600.0 |
Hypertrophy (benign)
of prostate |
| 600.1 |
Nodular prostate |
| 600.2 |
Benign localized hyperplasia
of prostate |
| 600.3 |
Cyst of prostate |
| 600.9 |
Hyperplasia of prostate,
unspecified
|
Pregnancy, Childbirth,
Puerperium (630-677)
As of October 1, the following codes will be
invalid:
| 645.00 |
Prolonged pregnancy,
unspecified as to episode of care or not applicable |
| 645.01 |
Prolonged pregnancy,
delivered, with or without mention of antepartum condition |
| 645.03 |
Prolonged pregnancy,
antepartum condition or complication |
Instead, six codes have been created to differentiate
between post-term pregnancy (over 40 weeks, but not more than
42 weeks gestation) and prolonged pregnancy (over 42 weeks
gestation). The new codes are:
| 645.10 |
Post-term pregnancy,
unspecified as to episode of care or not applicable |
| 645.11 |
Post-term pregnancy,
with or without mention of antepartum condition |
| 645.13 |
Post-term pregnancy,
antepartum condition or complication |
| 645.20 |
Prolonged pregnancy,
unspecified as to episode of care or not applicable |
| 645.21 |
Prolonged pregnancy,
with or without mention of antepartum condition |
| 645.23 |
Prolonged pregnancy,
antepartum condition or complication
|
Skin and Subcutaneous
Tissue (680-709)
The first new code in this chapter appears in
subcategory 692.7, Contact dermatitis and other eczema
due to solar radiation. Code 692.75
has been added to describe a condition called disseminated
superficial actinic porokeratosis (DSAP). This skin condition
occurs in people 30-40 years of age on sun-exposed skin surfaces.
Thickened lesions start around the sweat glands and then spread.
Seven new codes were added to subcategory 707.1,
Ulcer of the lower limbs, except decubitus, to further
specify ulcer sites. Code 707.1 will be invalid as of October
1.
The new codes are:
| 707.10 |
Ulcer of lower limb,
unspecified |
| 707.11 |
Ulcer of thigh |
| 707.12 |
Ulcer of calf |
| 707.13 |
Ulcer of ankle |
| 707.14 |
Ulcer of heel and midfoot;
plantar surface of midfoot |
| 707.15 |
Ulcer of other part of
foot; toes |
| 707.19 |
Ulcer of other part of
lower limb
|
Musculoskeletal System
and Connective Tissue (710-739)
The description for code 723.8, Other
syndromes affecting cervical region, has been expanded
to include occipital neuralgia.
Code 727.83, Plica syndrome,
has been added to identify pathological synovial plica of
the knee joint. If you code orthopedic cases, you know that
this code has been needed for a long time.
Symptoms, Signs and Ill-Defined
Conditions (780-799)
Subcategory 781.9, Other symptoms involving
nervous and musculoskeletal systems, has been expanded
to three codes, thereby making 781.9 invalid as of October
1.
The new codes are:
| 781.91 |
Loss of height |
| 781.92 |
Abnormal posture |
| 781.99 |
Other symptoms involving
nervous and musculoskeletal systems
|
Four codes have been added under subcategory
783.4 to better describe lack of normal physiological development.
Consequently, 783.4 will be invalid as of October 1. The new
codes are:
| 783.40 |
Unspecified lack of normal
physiological development |
| 783.41 |
Failure to thrive |
| 783.42 |
Delayed milestones |
| 783.43 |
Short stature
|
To describe adult failure to thrive,
code 783.7 has been added.
For reporting nonspecific findings on the examination
of blood, codes 790.01, Precipitous drop
in hematocrit, and 790.09, Other
abnormality of red blood cells, have been added.
A new subcategory, 792.5, has
been added to describe cloudy (hemodialysis) (peritoneal)
dialysis effluent.
Injury and Poisoning
Two codes have been added to this chapter:
| 995.7 |
Other adverse food reactions,
not elsewhere classified |
| 996.87 |
Complications of transplanted
organ, intestine
|
This chapter contains the largest number of
code changes this year. Most of these changes expand existing
subcategories to provide further specificity.
Nine new codes appear under V15, Other personal
history presenting hazards to health. All nine codes
are expansions of subcategory V15.0, Allergy other than
to medicinal agents. Therefore, as of October 1, code
V15.0 will no longer be valid. The new codes are:
| V15.01 |
Allergy to peanuts |
| V15.02 |
Allergy to milk products |
| V15.03 |
Allergy to eggs |
| V15.04 |
Allergy to seafood |
| V15.05 |
Allergy to other foods |
| V15.06 |
Allergy to insects |
| V15.07 |
Allergy to latex |
| V15.08 |
Allergy to radiographic
dye |
| V15.09 |
Other allergy, other
than to medicinal products
|
The following new codes appear under category
V21, Constitutional states of development. They are
to be used to identify patients whose current health problems
may be attributable to low birth weight status.
| V21.30 |
Low birth weight status,
unspecified |
| V21.31 |
Low birth weight status,
less than 500 grams |
| V21.32 |
Low birth weight status,
500-999 grams |
| V21.33 |
Low birth weight status,
1000-1499 grams |
| V21.34 |
Low birth weight status,
1500-1999 grams |
| V21.35 |
Low birth weight status,
2000-2500 grams
|
Under code V26, Procreative management,
subcategory V26.2 has been deleted and replaced by these more
specific codes:
| V26.21 |
Fertility testing |
| V26.22 |
Aftercare following sterilization
reversal |
| V26.29 |
Other investigation and
testing |
Under category V42, Organ or tissue replaced
by transplant, code V42.84 has been
added to describe intestinal transplant status.
Under V45.7, Acquired absence of organ,
the following codes have been added:
| V45.74 |
Acquired absence of organ,
other parts of urinary tract |
| V45.75 |
Acquired absence of organ,
stomach |
| V45.76 |
Acquired absence of organ,
lung |
| V45.77 |
Acquired absence of organ,
genital organs |
| V45.78 |
Acquired absence of organ,
eye |
| V45.79 |
Other acquired absence
of organ
|
Subcategory V49.8, Other specified problems
influencing health status, will no longer be valid as
of October 1. The new codes that replace this subcategory
are:
| V49.81 |
Postmenopausal status (age-related)
(natural)
|
| V49.89 |
Other specified conditions
influencing health status
|
The following codes have been added to category
V56, Encounter for dialysis and dialysis catheter care:
| V56.31 |
Encounter for adequacy
testing for hemodialysis |
| V56.32 |
Encounter for adequacy
testing for peritoneal dialysis
|
Code V58.83, Encounter for therapeutic drug
monitoring, has been added to subcategory V58.8, Other
specified procedures and aftercare.
Subcategory V67.0, Follow-up examination
following surgery, will be will be replaced with the
following new codes:
| V67.00 |
Follow-up examination,
following unspecified surgery |
| V67.01 |
Follow-up vaginal Pap
smear, status post hysterectomy for malignant conditions |
| V67.09 |
Follow-up examination
following other surgery
|
Subcategory V71.8 has been expanded to include
two new codes:
| V71.81 |
Observation for other
specified suspected conditions, abuse and neglect |
| V71.89 |
Observation for other
specified suspected conditions
|
The following new codes have been added to category
V76. The additional codes render subcategory V76.8, Special
screening for malignant neoplasms, other neoplasm,
invalid:
| V76.46 |
Special screening for
malignant neoplasms, ovary |
| V76.47 |
Special screening for
malignant neoplasms, vagina |
| V76.50 |
Special screening for
malignant neoplasms,intestine, unspecified |
| V76.51 |
Special screening for
malignant neoplasms, colon |
| V76.52 |
Special screening for
malignant neoplasms, small intestine |
| V76.81 |
Special screening for
malignant neoplasms, nervous system |
| V76.89 |
Special screening for
other malignant neoplasm
|
Code V77.9, Screening for other and unspecified
endocrine, nutritional, metabolic, and immunity disorders,
becomes invalid on October 1 with the addition of the following
two new codes:
| V77.91 |
Screening for lipoid
disorders; screening cholesterol level; screening for
hypercholesterolemia; screening for hyperlipidemia |
| V77.99 |
Other and unspecified
endocrine, nutritional, metabolic, and immunity disorders |
V82.8, Special screening for other specified
conditions, has been replaced with the following two
new codes:
| V82.81 |
Special screening for
osteoporosis |
| V82.89 |
Special screening for
other specified conditions
|
If you code accidents and injuries, you may
have had problems in the past classifying falls from skateboards,
snowboards, and other recreational gear. If so, you will appreciate
the following additions to category 885, Fall on same
level from slipping, tripping, or stumbling:
| E885.1 |
Fall from roller skates |
| E885.2 |
Fall from skateboard |
| E885.3 |
Fall from skis |
| E885.4 |
Fall from snowboard |
| E885.9 |
Fall from other slipping,
tripping or stumbling
|
Two new codes have been added under separate
categories to describe accidental and deliberate (i.e., assault
by) human bites.
| E928.3 |
Other and unspecified
environmental and accidental causes; accidental human
bite |
| E968.7 |
Assault by human bite
|
Operations on the Cardiovascular
System (35-39)
A new subcategory with two new codes appears
under category 39, Other operations on vessels. The
subcategory is 39.7, Endovascular repair
of vessel; endoluminal repair. The codes are:
| 39.71 |
Endovascular implantation
of graft in abdominal aorta |
| 39.79 |
Other endovascular graft
repair of aneurysm
|
Operations on Hemic and
Lymphatic System (40-41)
Three new codes appear under subcategory 41.0,
Bone marrow or hematopoietic stem cell transplant.
They are:
| 41.07 |
Autologous hematopoietic
stem cell transplant with purging |
| 41.08 |
Allogeneic hematopoietic
stem cell transplant with purging |
| 41.09 |
Autologous bone marrow
transplant with purging (with extracorporeal purging
of malignant cells from marrow)
|
Operations on the Digestive
System (42-54)
A single new code appears under category 46.9,
Other operations on intestine:
| 46.97 |
Transplant of intestine
|
Operations on Male Genital
Organs (60-64)
Two new codes have been added to subcategory
60.9, Other operations on prostate, to identify microwave
destruction procedures:
| 60.96 |
Transurethral destruction
of prostate tissue by microwave thermography |
| 60.97 |
Other transurethral destruction
of prostate tissue by other thermography
|
Operations on the Integumentary
System (85-86)
Although no new codes have been added to this
section, revisions to the category and code titles for skin
closure have been made to include closure of skin with staples
or adhesives.
Text changes in the following category
and code descriptions are underlined. The new titles
now read:
| 86.5 |
Suture or other closure
of skin and subcutaneous tissue |
| 86.59 |
Closure of skin
and subcutaneous tissue of other sites; Adhesives,
(surgical) (tissue); Staples; Sutures
|
Miscellaneous Diagnostic
and Therapeutic Procedures (87-99)
One new code appears under category 99.7, Therapeutic
apheresis:
| 99.75 |
Administration of neuroprotective
agent |
Practice
Makes Perfect!
Are you ready for some hands-on
practice? Code the examples on our Procedure
Practice page
based on codes effective October 1, 2000, and compare your
answers with our coding
recommendations.
Good luck!
Back to:
Top - Diagnostic
Codes - V
Codes - E
Codes - Procedure
Codes
If you have comments or suggestions about our
code selections or about any topic on our Coding Edge® pages,
please e-mail us at codingedge@lagunamedsys.com.
Please
understand, however, that we cannot answer inquiries
unless they relate directly to our published material.
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